Pendekatan Integratif dalam Manajemen Dengue

Penulis

  • Raymond R. Tjandrawinata Molecular Pharmacologist, Center for Pharmaceutical and Nutraceutical Research and Policy, Universitas Katolik Indonesia Atma Jaya, Jakarta, Indonesia

DOI:

https://doi.org/10.56951/699q0n64

Editorial

Dengue, sebagai salah satu penyakit tropis yang paling menantang pada abad ke-21, terus menghadirkan kompleksitas klinis dan epidemiologis yang signifikan di negara-negara berkembang, termasuk Indonesia. Dengan meningkatnya insiden infeksi dengue global dan keterbatasan opsi terapi definitif, fokus pengelolaan klinis bergeser ke arah optimalisasi terapi suportif serta pencarian strategi ajuvan yang dapat memperbaiki parameter klinis utama seperti hemodinamik dan jumlah trombosit. Dengan menempatkan dua intervensi, yakni Gelafusal (larutan gelatin) sebagai cairan koloid untuk resusitasi serta Psidii (ekstrak daun Psidium guajava) sebagai agen peningkat trombosit, dalam konteks bioetik, farmakodinamik, dan strategi klinis berbasis bukti, tinjauan ini memberikan refleksi kritis tentang peluang dan keterbatasan penerapan intervensi multimodal dalam manajemen dengue.

Referensi

1. Atik N, Tarawifa S, Avriyanti E, Rahmadi AR, & Hilmanto D. Psidium guajava L. extract increases platelet count through enhancement of stem cell factor expression in thrombocytopenic mice model. International Journal of Pharmacy and Pharmaceutical Science. 2018;10(1), 23–6.

2. Badan Pengawas Obat dan Makanan Republik Indonesia. (2004, Maret). Keterangan Pers No. KH.00.01.241.259.III.2004 tentang hasil penelitian pengembangan ekstrak daun jambu biji (Psidium guajava) menjadi fitofarmaka anti-demam berdarah. 2004, Mar 10. Available from: https://www.pom.go.id/

siaran-pers/keterangan-pers-no-kh-00-01-241-259-iii-2004-tentang-hasil-penelitian-pengembanganerkstrak-daun-jambu-biji-psidium-guajava-menjadi-fitofarmaka-anti-demam-berdarah.

3. Bhatt P, Gething PW, Brady OJ, Messina JP, FarlowAW, Moyes CL, Hay SI. The global distribution and burden of dengue. Nature. 2013;496(7446), 504–7.

4. Centers for Disease Control and Prevention. CDC DENV 1–4 Real Time RT PCR Assay. Retrieved July 2025, from CDC website.

5. Chen SD, Ma YT, Wei HX, Ou XR, Liu JY, Tian YL, Zhang C, Xu YJ, Kong Y. Use of colloids and crystalloids for perioperative clinical infusion management in cardiac surgery patients and postoperative outcomes: a meta-analysis. Perioperative Medicine; 2024;13(1);83.

6. Farraha S, Husni , Sari D, Rikarni, Rofinda ZD, Yulia D. Platelet to lymphocyte ratio in pediatric dengue patients: a key indicator of disease severity. Bioscientia Medicina: Journal of Biomedicine & Translational Research. 2024;9(5);1–7.

7. Guzman MG, Harris E. Dengue. Lancet. 2015;385(9966);453–65.

8. Himawan NSS, Akrom A, Darmawan E, & Herawati LW. An evaluation of the use of guava leaf extract capsules (Psidium guajava Linn.) on the thrombocyte level and length of hospital stay of dengue fever or dengue hemorrhagic fever patients at a private hospital in Indonesia. Journal of Medical and Dental Science Research. 2021; 8(10 Ser. I);17–24.

9. Huynh HD, Nargotra P, Wang HMD, Shieh CJ, Liu YC, Kuo CH. Bioactiv compounds from guava leaves (Psidium guajava L.): characterization, biological activity, synergistic effects, and technological applications. Molecules. 2025;30(6);1278.

10. Imad HA, Phumratanaprapin W, Phonrat B, Chotivanich K, Charunwatthana P, Muangnoicharoen S, et al. Cytokine expression in dengue fever and dengue hemorrhagic fever patients with bleeding and severe hepatitis. The American Journal of Tropical Medicine and Hygiene. 2020;102(5);943–50.

11. Balan C, Boros C, Turconi SIB, Hahn RG. (2025). Volume kinetics of Gelofusine 4% during vascular surgery. Clinical Pharmacokinetics. 2025;64;599-610.

12. Ngo NT, Cao XT, Kneen R, Wills B, Nguyen VM, Nguyen TQ, et al. Acute management of dengue shock syndrome: a randomized double-blind comparison of 4 intravenous fluid regimens in the first hour. Clinical

Infectious Diseases. 2001;32(2);204–13.

13. Pham DT, Nguyen DXT, Lieu R, Huynh QC, Nguyen NY, Quyen TTB, Tran DV. Silk nanoparticles for the protection and delivery of guava leaf (Psidium guajava) extract for cosmetic industry, a new approach for an old herb. Drug Delivery. 2023; 30(1), 2168793.

14. Singh S, Anupriya MG, Modak A, Sreekumar E. Dengue virus or NS1 protein induces trans endothelial cell permeability associated with VE cadherin and RhoA phosphorylation in HMEC-1 cells preventable by angiopoietin-1. Journal of General Virology. 2018;99(11);1497–508.

15. Utama IMS, Lukman N, Sukmawati DD, Alisjahbana B, Alam A, Murniati D, et al. Dengue viral infection in Indonesia: epidemiology, diagnostic challenges and mutations from an observational cohort study. PLoS Neglected Tropical Diseases. 2019;13(10);e0007785.

16. World Health Organization. Dengue guidelines for diagnosis, treatment, prevention and control. Geneva: WHO Press. 2022.

Diterbitkan

01-08-2025

Unduhan

Data unduhan tidak tersedia.

Cara Mengutip

[1]
Pendekatan Integratif dalam Manajemen Dengue. MEDICINUS 2025;38:3-6. https://doi.org/10.56951/699q0n64.